PAMA

Explaining the Legal News: Why ACLA Court Win Boosts Chances of PAMA Pricing Relief

By now, you've no doubt heard the news that the American Clinical Laboratory Association (ACLA) "won" its lawsuit against CMS over PAMA lab pricing. Only it's not as simple as that. The favorable US … [Read more...]

PAMA

Business Trends: More Hospitals Looking to Outsource Their Lab Testing

'Looking for new business opportunities? A new survey shows a substantial jump in the number of hospitals looking to outsource lab services. creating potential opportunity for labs. Although no … [Read more...]

FOCUS ON

ACLA Court Win May Tip the Battle Over PAMA Pricing

Take that, CMS! The American Clinical Laboratory Association (ACLA) can sue to get the agency's PAMA lab pricing scheme struck down after all. So ruled the US Court of Appeals for the District of … [Read more...]

REIMBURSEMENT

PAMAgeddon: Congress Tables Bill to Delay Next Round of Price Reporting for One Year

The PAMA data collection process has been a lightning rod for criticism from almost the moment CMS unveiled it. And now Congress may be getting ready to intervene. A newly proposed bill called … [Read more...]

FOCUS ON

Surviving PAMA: Keep an Eye on Industry Disruptors

A talking point of a G2 Lab Institute 2018 presentation deserves closer attention, especially given its implications for the lab industry. "Advantages and Disadvantages Confronting Labs in a … [Read more...]

CMS

PAMAgeddon: GAO Official Acknowledges Flaws in Lab Price Report as a Powerful Senator Enters the Scene

In November 2018, the U.S. Government Accountability Office (GAO) issued a controversial report suggesting that the new PAMA system will result in billions of dollars worth of Medicare overpayments … [Read more...]

REIMBURSEMENT

The Newest PAMA Controversy: The GAO Report & Intervention of a Powerful Senator

The recent moves by CMS to include certain hospital outreach labs as "applicable laboratories" for purposes of PAMA reporting and pricing (see National Intelligence Report (NIR), Dec. 31, 2018) has … [Read more...]

COMPLIANCE PERSPECTIVES

Compliance Perspectives: CMS Reviews PAMA Reporting Basics for Hospital Outreach Labs

PAMA reporting is tricky business in which mistakes and omissions carry the risk of civil monetary penalties of up to $10,000 per day. So, whether you're with a freestanding lab that's been through … [Read more...]

PAMA

Medicare Reimbursement: CMS Provides Needed PAMA Relief—But Newly Covered Hospital Labs Must Report in 2019

The battle between CMS and the lab industry over Medicare Part B pricing for lab tests could be on the road to resolution notwithstanding the ACLA's recent court loss. But even as the legal battle … [Read more...]

HEALTH CARE REFORM

Compliance Perspectives: PAMA Pitfalls & Survival Strategies

PAMA's deep Medicare reimbursement cuts have had a devastating impact on the lab industry. Recent CMS changes in the 2019 Final Rule should provide a degree of pricing relief but not until 2021. In … [Read more...]


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